I’m a Pharmacist – These Are the 12 Medicines You Should NEVER Take With Coffee
It’s an important part of most Americans’ morning routine: waking up, taking your meds, and making a cup of coffee.
However, taking certain medications alongside your morning cup of coffee can lead to disastrous side effects and serious complications, including high blood pressure and uncontrollable bleeding.
Pharmacists have told DailyMail.com which commonly used medications can interact with coffee and other caffeinated drinks.
Pharmacists told DailyMail.com that taking certain medications with coffee or other caffeinated drinks can lead to serious side effects
Antidepressants
Antidepressants have a long list of side effects and some can even make it harder to drink coffee in the morning.
Dr. Jennifer Bourgeois, pharmacist and health expert at One-person caretold DailyMail.com: ‘Caffeine can interact with these medications, potentially causing dangerous increases in blood pressure.’
Older types of antidepressants, such as tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs), prevent the body from processing caffeine properly.
Normally, caffeine is excreted through the kidneys in the urine.
However, these drugs disrupt this process, causing the caffeine to remain in the body longer.
Over time, this can lead to a persistently high heart rate and high blood pressure.
Dr. HaVy Ngo-Hamilton, Clinical Advisor at BuzzRx and pharmacist at the University of Minnesota Medical Center, said medicines such as fluvoxamine, pHenelzine (Nardil) and tranylcypromine (Parnate) were the worst for this.
The CDC estimates that one in ten Americans over the age of 12 uses antidepressants, a total of approximately 37 million people.
There are no known interactions between caffeine and newer SSRIs such as Zoloft, Lexapro, and Prozac.
OTC Cold and Allergy Medications
It is estimated that nearly three-quarters of American adults use over-the-counter cold and allergy medications to manage their symptoms.
Many of these agents contain the stimulant pseudoephedrine, which constricts the blood vessels in the nasal passages, thereby reducing swelling and congestion.
By doing this, pseudoephedrine stimulates cells in the brain responsible for the “fight or flight” response that protects us when we are threatened.
According to Dr. Ngo-Hamilton, drinking coffee can also worsen symptoms and make you feel nervous and anxious.
She points to over-the-counter medications such as Sudafed and Mucinex as popular products containing pseudoephedrine.
Dr. Ngo-Hamilton advises taking these medications two hours before or four hours after a cup of coffee.
Medicines for diabetes
Drinking sugary coffee with insulin could lead to blood sugar spikes, pharmacists warn
One in 10 Americans uses insulin to treat their diabetes. While insulin doesn’t interact directly with caffeine, it can clash with your morning coffee.
“It’s more like if you drink coffee, your blood sugar levels will rise, especially if it has milk and sugar in it,” Dr. Ngo-Hamilton said.
‘Your blood sugar level rises, making your medication less effective.’
According to a study from the University of California, drinking anything with caffeine can raise insulin and blood sugar levels. research from the American Diabetes Association.
In addition to insulin, Dr. Ngo-Hamilton also points to the blood sugar drug metformin, which was used by more than 20 million Americans in 2021 (according to the most recent data).
Dr. Ngo-Hamilton advises tracking your blood sugar levels to determine whether you can drink coffee with your medications.
Antibiotics
Antibiotics are prescribed for a wide range of infections. The CDC estimates that more than 230 million prescriptions will be written for these infections in 2022 alone.
This antibiotic can inhibit the metabolism of caffeine, leading to increased caffeine levels in the blood.
Dr. Bourgeois specifically referred to ciprofloxacin, also called Cipro, which is commonly used for bacterial infections such as urinary tract infections and bladder infections, infectious diarrhea, and sinus infections.
“Like cold and allergy medications, this antibiotic can inhibit the metabolism of caffeine, leading to higher caffeine levels in the blood,” she said.
Like over-the-counter medications, taking this medication with coffee can cause your heart to race and you to feel jittery.
Blood thinners
Warfarin is the oldest and most popular blood thinner in America. However, taking it with coffee can lead to excessive bleeding
A survey by the National Blood Clot Alliance found that eight million Americans take blood thinners to prevent blood clots.
According to the Cleveland Clinic, warfarin is both the oldest and most widely used form of blood thinners, accounting for about a quarter of all blood thinners prescribed in the U.S., or about 2 million.
According to Dr. Ngo-Hamilton, caffeine can slow the breakdown of blood thinners, leaving more of the drug in the body.
However, this is particularly dangerous, as too high a dose of the drug can lead to profuse bleeding, even from minor injuries such as a cut in paper.
Specifically for warfarin, Dr. Ngo-Hamilton advises waiting “at least six to eight hours” before drinking coffee, as this is “a very significant drug interaction between warfarin and caffeine.”
However, newer blood thinners such as Eliuis should not cause these interactions, she noted, although warfarin is more common.
Medicines for high blood pressure
The American Association of Colleges of Pharmacy estimates that 117 million prescriptions for beta blockers have been written to 26 million Americans.
These are designed to lower blood pressure and block the effects of the hormone epinephrine, or adrenaline. This helps to improve blood flow and slow the heart rate.
“Beta blockers work by slowing your heart rate so your heart doesn’t have to work as hard,” says Dr. Ngo-Hamilton.
“But if you then drink coffee, or caffeinated drinks, your heart rate increases and ultimately your blood pressure. This is not a direct interaction with medication, but it seems more like the beta blocker is counteracted.”
She advises taking these medications two hours before or four hours after a cup of coffee or other caffeinated drink.
Thyroid medications
Levothyroxine, which was developed to treat hypothyroidism, is one of the most prescribed medications in America, with 23 million prescriptions written each year.
However, Dr. Ngo-Hamilton cautioned that taking these medications with any type of food or water (including coffee) may decrease the amount of the drug absorbed by the body.
And a review from 2020 found that caffeine reduced absorption rate by as much as 50 percent.
Dr. William Franklin, Founder and Medical Director of Victory Medical in Texas, told DailyMail.com that people taking levothyroxine should take the drug “on an empty stomach with water and wait 30 to 60 minutes before taking caffeine.”
Medicines for Alzheimer’s
Experts estimate that one in 10 American adults over age 65 has been diagnosed with Alzheimer’s, the most common form of dementia.
Drugs that treat the symptoms of the disorder, called cholinesterase inhibitors, prevent the breakdown of acetylcholine, a chemical that helps with memory and thinking.
However, when you take these medications with coffee, the blood-brain barrier narrows, making it harder for the drugs to reach the brain. “Ultimately, it reduces their effectiveness,” Dr. Ngo-Hamilton said.
She identified Donepezil and Rivastigmine as the most likely culprits for this effect.
She also noted that people taking these medications should take them two hours before or four hours after coffee.
Medicines for osteoporosis
Taking osteoporosis medications such as risendronate and ibandronate with coffee may increase the risk of fractures
Osteoporosis is a condition in which bones become weak or brittle over time, so even minor stressors, such as coughing, can cause bones to break.
The CDC estimates that 10 million Americans over 50 are living with the condition and take medications such as risendronate and ibandronate to slow bone loss.
Like thyroid medications, when taken with coffee, these medications may not be absorbed properly by the body and may therefore be less effective.
As with thyroid medications, Dr. Ngo-Hamilton advises waiting about two hours before drinking coffee or eating food.
Medicines for asthma
Many of the 25 million Americans who suffer from asthma rely on bronchodilators, a class of prescription medications that relax and widen the airways.
However, mixing bronchodilators such as aminophylline and theophylline with coffee can worsen the drug’s side effects, such as irritability and restlessness.
“Especially if you’re new to medications, you should see how it goes before you start drinking coffee. Coffee can make the side effects worse,” Dr. Ngo-Hamilton said.
If you do want to drink coffee, she advises taking these medications four hours before or after.
ADHD medications
According to CDC data, just under one in 10 Americans under the age of 17 has been diagnosed with ADHD, with approximately 41 million prescriptions written.
These medications help regulate neurotransmitters such as dopamine and norepinephrine to improve focus, attention, and impulse control.
However, taking medications such as Adderall and Ritalin with coffee can make them less effective and make you hyperactive.
“Both ADHD medications and caffeine are stimulants. When combined, they can amplify each other’s effects, leading to overstimulation,” Dr. Bourgeois said.
Antipsychotics
According to the Cleveland Clinic, approximately 4 million Americans use some form of antipsychotic medication.
Some of the most common examples are clozapine, risperidone, and olanzapine. These are typically prescribed for serious health conditions such as schizophrenia and bipolar disorder.
These agents regulate neurotransmitters such as dopamine and serotonin, thereby reducing symptoms such as hallucinations.
However, Dr. Ngo-Hamilton cautioned that coffee can reduce the rate at which medications are absorbed by the body. And if someone is suffering from mania, the medications may not be able to pull them out of it.
She advises not drinking coffee at all if a patient is experiencing a manic episode.
